Dr. Christie C. Smith’s Post

In 2025, 5% of Medicare Advantage enrollees in MA-PDs or about 1.4 million people, are in a plan that has been terminated for the coming year and will not be automatically assigned to another plan. #insurance #insuranceindustry #Medicare #MedicareAdvantage

If you’re on Medicare, you’ll be getting one or two Annual Notice of Change letters in your mail or email this September about your 2025 coverage and costs. You may be tempted to ignore what looks like junk, as nearly a third of recipients do, according to an eHealth survey. Don’t. Figure on spending about 30 minutes closely reading your Annual Notice of Change to see exactly what will be different in 2025 and whether you’ll want to switch plans or coverage next year as a result. #medicare #seniors #insurance #medical #healthcare #employees #employers #brokers #advisors #parents #grandparents #notice

Insurance company-run Medicare Advantage plans, which now cover over half of seniors, have been under fire for years for upcoding, gaming quality ratings and giving seniors and their physicians the runaround with excessive use of prior authorization and outright denials of care. MedPAC has documented MA plans receive nearly $50 billion annually in excessive payments compared to traditional Medicare. Last Friday, CMS proposed giving MA plans another 4.3% bump for 2026 plans. That's crazy. There has to be a better way. I outline some potential solutions, drawn from the latest issue of Health Affairs, in my latest GoozNews post: https://lnkd.in/gbQQNH2F

Recently, Aetna and Anthem joined a growing number of insurers that have cut commissions on new Medicare Advantage enrollments—right in the middle of Medicare’s Annual Enrollment Period. This trend jeopardizes seniors' access to the personalized support they need to navigate complex Medicare options. NAIFA has called on CMS to address these cuts, warning that they could leave beneficiaries relying on call centers that lack local insight and personalized care. Agents and Professional Advisors have long been trusted partners in guiding seniors through healthcare choices, helping them control costs and understand benefits. However, these commission cuts risk sidelining dedicated advisors. This isn't new; insurers also eliminated and later reduced commissions for the people under 654 - The ACA and Covered California, showing little regard for advisors’ role in supporting families. By repeatedly reducing or eliminating commissions, insurers undermine trust within the industry, forcing advisors to shoulder the burden of low compensation while continuing to serve their clients with the same level of dedication. These practices not only devalue the essential role of licensed agents but also risk leaving seniors unsupported in making crucial healthcare decisions. As the trend continues, NAIFA remains a steadfast advocate, opposing ill-advised regulatory measures and fighting for the rights of agents and the clients they serve. Read this article for details. #MedicareAdvantage #NAIFAAdvocacy #ProtectConsumers #AgentSupport #MedicareEnrollment #HealthcareAdvocacy #InsuranceIndustry #SeniorCare #SupportAgents #HealthcareAccess #CommissionCuts #CMSActionNeeded #InsuranceAdvocacy #ConsumerProtection #MedicareMatters #naifaproud

📅 We're now deep into Medicare's AEP, which runs annually from October 15th through December 7th. Here's an article about the 4 main changes coming to Medicare insurance in 2025. 👉 Just like an expert caddy, Medicare Caddy, Llc, DBA Senior Insurance Caddy, knows the course. We're here to Engage, Educate, Evaluate & Enroll...and ultimately, Empower seniors regarding the dizzying Medicare maze of options. #Medicare #Seniors #AEP #SeniorInsurance #2025medicare https://lnkd.in/eYcrbxks

📢 Important Update for 2025: Medicare Advantage Plans Face Changes As we approach the Medicare Annual Enrollment Period (starting October 15), it's critical to stay informed about changes coming to Medicare Advantage (MA) plans in 2025. Unfortunately, many insurers are signaling reductions in benefits and service areas while continuing practices that maximize overpayments. Here's what we know so far: 1. UnitedHealth Scrutiny: The largest MA plan, UnitedHealth, is under investigation for billing practices that inflated profits. From 2019 to 2021, they received nearly $50 billion from diagnoses that no doctor treated. 2. Insurers Scaling Back: Major MA providers like Humana, Aetna, and Centene (WellCare) are preparing to shed members, exit certain markets, and reduce benefits to cut costs. These actions will impact thousands of members in various states, as insurers prioritize profits over care. 3. Impact on Enrollees: The reduction in benefits comes amid reports that MA plans are overpaid by $83 billion due to practices like upcoding and favorable selection. Even with these overpayments, insurers like Humana are predicting the loss of several hundred thousand members next year. It's clear that 2025 will bring significant shifts in the Medicare Advantage landscape. Now, more than ever, it's crucial to review your options carefully during this upcoming enrollment period. Don’t hesitate to reach out if you need help navigating these changes. Feel free to connect with me for personalized advice on your Medicare options! Julio (Ricky) Gonzalez, RMIP™ President and CEO Pinnacle Financial Group, Inc. #MedicareAdvantage #Medicare2025 #HealthCareChanges

🌟 Important Update for Medicare Advantage Plans! 🌟 CMS is recalculating Medicare Advantage star ratings, a move that could impact millions of beneficiaries. The updated methodology aims to provide more accurate reflections of plan performance, ensuring better quality and service for enrollees. Key Points: Adjustments to rating calculations will focus on enhancing care quality. Plans may experience changes in their star ratings, affecting beneficiaries' choices. Stay informed and review your plan details during the upcoming open enrollment period. At Amsive, we’re here to help you navigate these changes and find the best plan for your needs. Read more: https://lnkd.in/eBuhe3_f #MedicareAdvantage #Healthcare #Insurance #Amsive #MedicareUpdates

(FORTUNE) - "Who should, and shouldn’t, sign up for the new Medicare Prescription Payment Plan." If you sign up for M3P with the Part D prescription plan you choose for 2025—a stand-alone plan or one that’s part of a private insurer’s Medicare Advantage plan—you won’t pay for medications at the pharmacy. Finally Access To AFFORDABLE Health & DENTAL Insurance Plans At: HI4E.org #MedicarePartD #MedicartDPrescriptions #OpenEnrollment #MedicareDonutHole #MedicareOpenEnrollment #MedicareAdvantagePlans #TrumpMedicareReforms #AffordableHealthInsurance #HI4E.Org #MedicarePrescriptions #TrumpHealthPlans #BidenDrugPlan #InflationReductionAct #MedicareAdvantagePrescriptions #MedicareAdvantagePlans #HealthInsurance4Everyone #SeniorCare #ObamacareOpenEnrollment #ObamacareDrugCoverage #MedicarePartD #Pharmacists #M3P #HealthInsurance4Everyone #Fortune #HealthAndLifeSolutions #MedicareDrugs

ABOUT MEDICARE PARTS A AND B WWW.DONPBAKER.COM Medicare Parts A and B are the two main components of Original Medicare, each covering different aspects of healthcare: Medicare Part A (Hospital Insurance) Coverage: Primarily covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Cost: Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years. However, there are costs like deductibles and coinsurance for services. Medicare Part B (Medical Insurance) Coverage: Helps cover services from doctors and other healthcare providers, outpatient care, home health care, durable medical equipment, and some preventive services. Cost: Most people pay a monthly premium for Part B, which varies based on income. There are also deductibles and coinsurance. Would you like more details on how to enroll or the specific costs involved? WWW.DONPBAKER.COM Tailored Coverage for Life, Medicare, Annuities, and Business Conditions For individuals with health conditions such as Type 2 Diabetes, Pre-diabetes, Cancer, Cardiovascular Disease, Diabetic Nephropathy, COPD, or those who are wheelchair-bound or require oxygen, we recognize your specific insurance requirements. Together, we can craft a strategy that not only meets your immediate needs but also lays the groundwork for long-term stability and peace of mind. Thank you for considering DON P. BAKER FINANCIAL GROUP as your trusted health and financial well-being partner. DON P. BAKER FINANCIAL GROUP DON P. BAKER 713-581-4366 DONPBAKER@GMAIL.COM WWW.DONPBAKER.COM #insuranceagent #HealthInsurance #Social Security #insuranceservices #Diabetes #COPD #annuity #DISABILITYINSURANCE #GOVEMENTEMPLOYEES #lifeinsurance #insurance #financialplanning #businessinsurance #insurancebroker #lifeinsuranceagent #retirement #financialadvisor#retirementplanning #finalexpense

Eileen Appelbaum is Co-Director of the Center for Economic and Policy Research, writes that “taxpayers who are footing the bill for the Medicare Advantage system. It is estimated that privatized Medicare overcharges anywhere from $88 billion to $140 billion every year https://lnkd.in/g4zA3YsD. If there’s any "advantage" in this scheme, it accrues to the private insurers, which at this point are making more money from Medicare than they do from selling their other insurance products.” Carefully compare Medicare Advantage plans with traditional Medicare, considering coverage, costs, and provider networks. Be cautious of aggressive marketing tactics and thoroughly research the reputation and performance of Medicare Advantage providers. Seniors can change their Medicare coverage during the Annual Enrollment Period (October 15 - December 7) or Special Enrollment Periods triggered by specific life events such as moving, losing current coverage, or qualifying for Medicaid. https://lnkd.in/gtCmJ9bZ